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Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

ABSTRACT: BACKGROUND:Curriculum development and implementation for internal medicine point-of-care ultrasound (IM POCUS) continues to be a challenge for many residency training programs. Education indicators may provide a useful framework to support curriculum development and implementation efforts across programs in order to achieve a consistent high-quality educational experience. OBJECTIVE:This study seeks to establish consensus-based recommendations for education indicators for IM POCUS training programs in Canada. DESIGN:This consensus study uses a modified nominal group technique for voting in the initial round, followed by two additional rounds of online voting, with consensus defined as agreement by at least 80% of the participants. PARTICIPANTS:Participants were 22 leaders with POCUS and/or education expertise from 13 Canadian internal medicine residency programs across 7 provinces. MAIN MEASURES:Education indicators considered were those that related to aspects of the POCUS educational system, could be presented by a single statistical measure, were readily understood, could be reliably measured to provide a benchmark for measuring change, and represented a policy issue. We excluded a priori indicators with low feasibility, are impractical, or assess learner reactions. Candidate indicators were drafted by two academic internists with post-graduate training in POCUS and medical education. These indicators were reviewed by two internists with training in quality improvement prior to presentation to the expert participants. KEY RESULTS:Of the 52 candidate education indicators considered, 6 reached consensus in the first round, 12 in the second, and 4 in the third round. Only 5 indicators reached consensus to be excluded; the remaining indicators did not reach consensus. CONCLUSIONS:The Canadian Internal Medicine Ultrasound (CIMUS) group recommends 22 education indicators be used to guide and monitor internal medicine POCUS curriculum development efforts in Canada.

SUBMITTER: Ambasta A

PROVIDER: S-EPMC6816798 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

Ambasta Anshula A Balan Marko M Mayette Michael M Goffi Alberto A Mulvagh Sharon S Buchanan Brian B Montague Steven S Ruzycki Shannon S Ma Irene W Y IWY

Journal of general internal medicine 20190625 10

<h4>Background</h4>Curriculum development and implementation for internal medicine point-of-care ultrasound (IM POCUS) continues to be a challenge for many residency training programs. Education indicators may provide a useful framework to support curriculum development and implementation efforts across programs in order to achieve a consistent high-quality educational experience.<h4>Objective</h4>This study seeks to establish consensus-based recommendations for education indicators for IM POCUS ...[more]

PMID: 31240603

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Project description:BackgroundSignificant gaps currently exist in the Canadian internal medicine point-of-care ultrasound (POCUS) curriculum. From a learner's perspective, it remains unknown what key POCUS skills should be prioritized. This needs assessment study seeks to establish educational priorities for POCUS for internal medicine residents at five Canadian residency training programs.MethodsAll internal medicine trainees [postgraduate year (PGY) 1-5] from five internal medicine residency training programs in Canada (n?=?598) were invited to complete an online survey on 15 diagnostic POCUS applications, 9 bedside procedures, and 18 POCUS knowledge items. For POCUS applications and procedures, participants were asked how applicable they are to patient care in internal medicine and the participants' reported skills in those domains. Self-reported knowledge and skills were rated on a 5-point Likert scale, where 1?=?very poor and 5?=?very good. Applicability was rated, where 1?=?not at all applicable and 5?=?very applicable.ResultsA total of 253 of 598 residents (42%) participated in our study. Data from one centre (n?=?15) was removed because of low response rate (15%) and significant baseline differences between those trainees and the remaining participants. Of the remaining analyzable data from four training programs (n?=?238), participants reported highest applicability to internal medicine for the following applications and procedures: identifying ascites/free fluid [mean applicability score of 4.9?±?standard deviation (SD) 0.4]; gross left ventricular function (mean 4.8?±?SD 0.5) and pericardial effusion (mean 4.7?±?SD 0.5); thoracentesis (mean score 4.9?±?SD 0.3), central line insertion (mean 4.9?±?SD 0.3), and paracentesis (mean 4.9?±?SD 0.3), respectively. Overall reported knowledge/skills was low, with skill gaps being the highest for identifying deep vein thrombosis (mean gap 2.7?±?SD 1.1), right ventricular strain (mean 2.7?±?SD 1.1), and gross left ventricular function (mean 2.7?±?SD 1.0).ConclusionsMany POCUS applications and procedures were felt to be applicable to the practice of internal medicine. Significant skill gaps exist in the four Canadian training programs included in the study. POCUS curriculum development efforts should target training based on these perceived skill gaps.

Project description:BackgroundAbortion has been decriminalized in Canada since 1988 and is considered an essential medical service. There is concern that decreasing numbers of abortion providers may impair access to abortion. This study examined the quantity of exposure and education that Canadian family medicine residents receive on abortion during training and their preparation to provide abortions. In addition, the study assessed residents' attitudes, intention and expressed competency to provide abortion in future practice and the association between medical training and changes in these factors.MethodsThe authors developed a 21-item survey in consultation with experts in medical education. The survey was distributed online in 2016. A total of 1517 family medicine residents in their first, second and third year of training attending 8 English language schools across Canada were invited to participate. Associations between attitudes, education, exposure and intention were assessed using relative risks based on bivariate analysis of self-reported measures and odds ratios from ordered logistic regression.ResultsThe response rate was 28.7% (436/1517). The majority of residents, 79%, reported never observing or assisting with an abortion during training. Similarly, 80% of residents reported receiving less than 1 hour of formal education on abortion. Residents strongly supported receiving abortion education. Self reported exposure to a single abortion during training was associated with an increase in residents' intention (RR?=?1.95, 95% CI 1.54-2.47) and self-rated competency to provide a medical abortion (RR?=?2.16, 95% CI 1.60-2.93). Twenty five percent of residents were unaware of ethical and legal requirements towards abortion provision and referral.ConclusionsCanadian family medicine residents receive little education or exposure to abortion during training most do not feel competent to provide abortion services. Residents expressed strong support for receiving abortion training. The Canadian College of Family Physicians curriculum does not currently include abortion as a training objective. The authors argue there is a need for family medicine training programs to increase education and exposure to abortion during residency, while respecting residents' rights to opt out of such training. Failure to do so may impair future access to abortion provision.

Dataset Information

Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

Publications

Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

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